Abstract
OBJECTIVE AND IMPORTANCE: Type III odontoid fractures are generally thought of as unstable fractures that can be successfully treated with an external orthosis. However, there is a rare subtype of Type III odontoid fractures that is similar in the degree of instability to atlanto-occipital dislocation injuries. Not recognizing or not treating this injury urgently and aggressively could lead to devastating iatrogenic neurological injuries such as quadriplegia and fatal lower brainstem palsies. CLINICAL PRESENTATION: We present the case of a 73-year-old woman with a vertically distracted Type III odontoid fracture and associated quadriparesis and brainstem deficits. The patient was kept in a rigid collar, placed in a kinematic bed, and admitted to the trauma service for the management of her life-threatening systemic injuries. Traction was not applied. INTERVENTION: As soon as the patient was systemically stable, she was taken to the operating room for C1-C2 fixation with a screw-rod construct supplemented by cable and structural iliac crest bone graft. CONCLUSION: Delayed recognition of this subtype of Type III odontoid fracture could have fatal or highly morbid consequences, such as quadriparesis/-plegia, lower brainstem dysfunction, and ventilator-dependence, for the patient. It is important to keep a high level of suspicion for this unusual subtype of Type III odontoid fracture.
| Original language | English |
|---|---|
| Journal | Neurosurgery |
| Volume | 58 |
| Issue number | 4 |
| DOIs | |
| State | Published - Apr 1 2006 |
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Keywords
- Cervical spine fracture
- Type III odontoid fracture
- Unstable spine fracture
ASJC Scopus subject areas
- Clinical Neurology
- Surgery
Cite this
Vertically unstable type III odontoid fractures : Case report. / Jea, Andrew; Tatsui, Claudio; Farhat, Hamad; Vanni, Steven; Levi, Allan D.
In: Neurosurgery, Vol. 58, No. 4, 01.04.2006.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Vertically unstable type III odontoid fractures
T2 - Case report
AU - Jea, Andrew
AU - Tatsui, Claudio
AU - Farhat, Hamad
AU - Vanni, Steven
AU - Levi, Allan D
PY - 2006/4/1
Y1 - 2006/4/1
N2 - OBJECTIVE AND IMPORTANCE: Type III odontoid fractures are generally thought of as unstable fractures that can be successfully treated with an external orthosis. However, there is a rare subtype of Type III odontoid fractures that is similar in the degree of instability to atlanto-occipital dislocation injuries. Not recognizing or not treating this injury urgently and aggressively could lead to devastating iatrogenic neurological injuries such as quadriplegia and fatal lower brainstem palsies. CLINICAL PRESENTATION: We present the case of a 73-year-old woman with a vertically distracted Type III odontoid fracture and associated quadriparesis and brainstem deficits. The patient was kept in a rigid collar, placed in a kinematic bed, and admitted to the trauma service for the management of her life-threatening systemic injuries. Traction was not applied. INTERVENTION: As soon as the patient was systemically stable, she was taken to the operating room for C1-C2 fixation with a screw-rod construct supplemented by cable and structural iliac crest bone graft. CONCLUSION: Delayed recognition of this subtype of Type III odontoid fracture could have fatal or highly morbid consequences, such as quadriparesis/-plegia, lower brainstem dysfunction, and ventilator-dependence, for the patient. It is important to keep a high level of suspicion for this unusual subtype of Type III odontoid fracture.
AB - OBJECTIVE AND IMPORTANCE: Type III odontoid fractures are generally thought of as unstable fractures that can be successfully treated with an external orthosis. However, there is a rare subtype of Type III odontoid fractures that is similar in the degree of instability to atlanto-occipital dislocation injuries. Not recognizing or not treating this injury urgently and aggressively could lead to devastating iatrogenic neurological injuries such as quadriplegia and fatal lower brainstem palsies. CLINICAL PRESENTATION: We present the case of a 73-year-old woman with a vertically distracted Type III odontoid fracture and associated quadriparesis and brainstem deficits. The patient was kept in a rigid collar, placed in a kinematic bed, and admitted to the trauma service for the management of her life-threatening systemic injuries. Traction was not applied. INTERVENTION: As soon as the patient was systemically stable, she was taken to the operating room for C1-C2 fixation with a screw-rod construct supplemented by cable and structural iliac crest bone graft. CONCLUSION: Delayed recognition of this subtype of Type III odontoid fracture could have fatal or highly morbid consequences, such as quadriparesis/-plegia, lower brainstem dysfunction, and ventilator-dependence, for the patient. It is important to keep a high level of suspicion for this unusual subtype of Type III odontoid fracture.
KW - Cervical spine fracture
KW - Type III odontoid fracture
KW - Unstable spine fracture
UR - http://www.scopus.com/inward/record.url?scp=33645769940&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33645769940&partnerID=8YFLogxK
U2 - 10.1227/01.NEU.0000208555.34661.CD
DO - 10.1227/01.NEU.0000208555.34661.CD
M3 - Article
C2 - 16575303
AN - SCOPUS:33645769940
VL - 58
JO - Neurosurgery
JF - Neurosurgery
SN - 0148-396X
IS - 4
ER -